Abstract
Purpose: To assess the resolution of intracardiac echogenic focus in gestation and to evaluate its association with fetal cardiac structural defects. Materials and Methods: Retrospective data of fetal echocardiography from January 2014 to December 2016 in low-risk pregnancies were collected. The study variables included observation resolution data of fetuses with intracardiac echogenic foci detected in the second-trimester, and follow-up data in the third-trimester. The Chi-square test was used to determine the association between intracardiac echogenic foci and fetal cardiac defects. Additionally, several statistical measures of performance for the foci as predictive markers were calculated. Results: The authors examined 8,120 fetuses. Among 531 fetuses with intracardiac echogenic foci, the overall incidence rate was 6.5% on a sonogram at 22-28 gestational weeks. The left ventricle was the most common site. Significant differences were observed between the locations and features of changes in the foci (χ2 = 18.68, p = 0.0009). No significant associations were found between the foci locations and fetal cardiac structural defects (Pfisher=0.28), or between the foci and cardiac defects [χ2 = 0.91, p = 0.34, OR = 0.72 with 95% confidence interval (0.40, 1.30)]. Conclusions: In most cases, isolated intracardiac echogenic focus was a transient sonographic marker during the gestational period. However, foci in the right ventricle were more stable than in the other locations. Intracardiac echogenic foci were not associated with cardiac defects, despite persistence in the third trimester.
Highlights
Fetal echocardiography is performed to detect structural cardiac anomalies
Patients were categorized as low-risk pregnancy based on the following criteria: (1) pregnant women aged < 35 years with singleton pregnancies, (2) normal results of maternal aneuploid serum “triple screen”, (3) fetuses with isolated intracardiac echogenic focus, and (4) women without prior history of congenital heart disease or aneuploid offspring
Cardiac echogenic focus was identified in 531 fetuses among 8,120 (6.5%) low-risk pregnant women in the second-trimester during the study period
Summary
Intracardiac echogenic focus may be observed in the four-chamber view. It was first described by Schechter et al in 1987. These small discrete structures were considered to be incomplete fenestrations or mineralizations of the chordae tendineae and/or the papillary muscles [1, 2]. Numerous reports have discussed this finding and its possible associations in cross-sectional populations, but the significance of this marker is still debated. This finding increases maternal and family anxiety, and is the reason behind referrals from doctors or requests from patients for fetal echocardiography examination
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